The mechanics of this game are almost identical to real life. You buy and sell commodities and commodities futures and do basically nothing with them until the market decides that they're more valuable or you can offload them at someone else's expense. The organ-y framing is a good way to highlight the parasitic nature of speculative fake-wealth generation that directly feeds off of the suffering (in this game more literally) of common people.

My favorite part of Organ Trading is how fast it starts. Once you hit the trade bell you're just going. The tutorial is playing the game while Mentaur bullies/bothers you, so it never slows the player down. Keeping up this breakneck pace during market times is where this game is at its strongest.

The weakness is Organ Trading systematically is that this breakneck pace does not last. Past a certain point, playing the market slowly and patiently is much more profitable than actually buying and selling organs or filling orders. The game naturally ends much faster than this occurs, though. I played on one save file the whole time before I got bored, maybe if you switched saves every few endings you won't have this problem as quickly?